Fill and Sign the Response Counterclaim Form

PRINT in BLACK ink Enter the name of the county in which this case was filed by your spouse. STATE OF WISCONSIN, CIRCUIT COURT,       COUNTY For Official Use Enter your spouse’s name (he/she is the petitioner). In RE: The marriage of: Petitioner:       First name Middle name Last name andOn the far right, check if your spouse filed for divorce or legal separation. Response and Counterclaim D ivorce-40101 Legal Separation-40201 Case No.       Enter your name (you are the respondent). Respondent:       First name Middle name Last name Enter the case number. RESPONSE I am the respondent in this action. A. I accept all the statements made in section A of the Petition to be true and correct. Yes No I am making the following changes:       B. I accept all the statements made in section B of the Petition to be true and correct. Yes No I am making the following changes:       C. I accept all the statements made in section C of the Petition to be true and correct. Yes No I am making the following changes:       D. I accept all the statements made in section D of the Petition to be true and correct. Yes No I am making the following changes:       FA-4113V, 01/08 Response and Counterclaim §§767.215 and 822.29, Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 1 of 2Read through section A, section B, section C, and section D of the Petition. If all the statements are true, check yes in the appropriate section. If any statement or fact is untrue or incorrect, check no in the appropriate section and enter the correct information on the lines. Response and Counterclaim Page 2 of 2 Case No. ____________ COUNTERCLAIM I REQUEST THE FOLLOWING RELIEF FROM THE COURT: A . A judgment of: 1. Divorce: This marriage is irretrievably broken. 2. Legal Separation : This marriage is broken and the reason I am requesting a legal separation and not a divorce is:       3. Dismissal of this action. B. Enter other orders as it deems just and equitable. STOP! If you have minor children, take this document to a Notary Public BEFORE you sign it. After you have been sworn by a Notary Public, sign and print your name and date the document in front of the Notary Public. If you do not have minor children, sign, print your name and date. A Notary is not required. Signature       Print or Type Name       Date Have the Notary Public sign, date, and seal the document. Subscribed and sworn to before me on       Notary Public, State of Wisconsin My commission expires:       (Seal) FA-4113V, 01/08 Response and Counterclaim §§767.215 and 822.29, Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 2 of 2Check 1, 2, or 3. If 2, explain why you are requesting a legal separation and not a divorce.